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The eyeHeme : A NovelApproach to Anemia
Diagnosis Team Dx, D-lab Health
Arianne JongSeema KackerKristin KuhnSpring 2010
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Overview
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Motivation Impact of Anemia
Anemia is a primary contributor to the globalburden of diseaseo
2 billion people worldwide
impaired development, reduced productivityincreased infection
riskmore rapid disease progression
o 42% of all pregnant women20% of maternal deaths (>120,000
peryear)
birth complications, infant mortality(>134,000 per year)o
40-50% of preschool children in the
developing world are anemico $50 Billion in GDP lost each
year
Global Health Risks Report: Mortality and burden of disease
attributable to selected major risks.2009.
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MotivationNine out of 10 anemics live in the developing
world,but anemia affects all countries and demographics
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BackgroundAnemia
Definition: inability of red blood cells to carryenough oxygen
to the tissues of the body
o measured by hemoglobin concentration Causes: nutritional and
due to infection
o Iron-deficiency: >50% of caseso Infection (malaria,
hookworms, etc.)o Other nutritional deficiencies
Challengeo Treatment is known, but anemia is under-
diagnosed and undertreated
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Diagnostic Methods:Invasive
Methodso Complete blood count
[Hb]Hematocrit - volumeoccupied by RBCs inplasmaMean Corpuscular
Volume:average size of RBCs
o Alternative in-vitro methodso HemoCue
Limitations Painful Risk of infection
Training required Costly Result may not beimmediately
available
www.hub a es.c
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Diagnostic Methods: Non-Invasive
Methods Few widely available
devices
Mostly qualitative analysisof obvious clinical signs Eyelid,
tongue, palmar and
nailbed observation, patientinterview
Sensitive only to severeanemia
Subjective Requires training/experience
Karnath,
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Subcutaneous Absorbance:Modified Pulse-Oximeter
Concept Sensitivity Impure sample
(multiple species of Hb, blood, tissue, etc.)
Challenges
A
= log
I 0
I = [ Hb
]l e
D = log
I 0
I = [ Hb ]l m
Beer-Lambert Law:
Attenuation:
Measure variation inpath length withsonomicrometer
Aldrich et al., 2002
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Occlusion Spectroscopy -OrSense
Concept Occlusion of blood
flow causes low signal-
noise ratio Measures
transmittance usingmultiple wavelengths
Concept
Amir et al., 2007
Challenges
Cost issues Appropriate?
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Reflectance Spectroscopy
Nadeau et al.,
2001http://www.nrc-cnrc.gc.ca/eng/projects/ibd/diffuse-
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Orthogonal PolarizationSpectral Imaging
Concept Most polarized light
retains polarization
Deep-penetrating light(to blood vessels)becomes depolarized
Sublingual mucosa Hemoscan, Cytoscan
Nadeau et al., 2001
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Optical Diagnosis via theEye
Method
Jay et al., 2007
Reflectance obtained fromblood vessels in the eye
Fundus, Conjunctiva Obtain/view reflectedsignal
Modifiedophthalmoscope?
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Strategy: Goals for AppropriateDesign
-> Initial screening device-> Quantitative, butspecific
numeric outputnot required
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Proposal- Use: palpebral conjunctiva
-Why?-Clinical signs-Mucosal tissue
- Via: reflectance- How?
-filter with photodiode
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Proposal7.3 g/dL (Anemic) 12.7 g/dL (Mildly Anemic)
14.0 g/dL (Non-Anemic) 14.5 g/dL (Non-Anemic)
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The Concept: Reflectance
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The Concept: ReflectanceAnemic and Non-Anemic Blood
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The Concept: ReflectanceTissue and Hemoglobin
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Proposal: Working Prototype
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Progress
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Future Directions
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Prototype Development
multiple wavelengths
alternative surfaces(mouth, nostril, e.g.) multimodal
(combine
absorbance, reflectance,fluorescence)
Increase sensitivity and precision
Nathan Cooke, 2010
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Prototype Development Determine best light source
Test using Intralipid, blood
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Product Development
Power source User interface Patient testing
o Pilot study: small NGO,health care provider
o Comparison to blood tests Deployment
o
Integration into healthsystemo Two-tiered pricing system
Sensor
Light
Nathan Cooke, 2010
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510(k) Predicate Devices
Ophthalmoscope
Orsense's absorbance-basedhemoglobin sensor
SPO Medical's
reflectance-basedpulse oximeter
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Innovation Compass
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Impact on Global Health
Better statistics
More awareness
More funding(fortified rice, iron supplements,
etc.)
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Thank you!
Questions?
